Child: care, health and development, 1982, 8, 123-131.

A preliminary investigation on the use of the

Portage system in day nursery settings
J. C. CLEMENTS, J. SMITH, B. SPAIN and J. WATKEYS
Department of Community Medicine, King's College Hospital and
Department of Psychology, Institute of Psychiatry, London

Accepted for publication 14 April 1982

Summary The paper describes the impact of a training programme

for local authority day nursery staff on the use of the Portage system
with handicapped children. The results suggest that the staff mastered
the techniques and were able to continue using them, though some
modification to the system seems indicated for these settings. These
findings were discussed in the light of more general issues about the
support needed for day nursery staff.

The provision of day-care for children under 5 years old has been the
subject of much recent debate (Hughes et al. 1980). Although there
is controversy about the quantity and quality of such provision, it is
now more generally accepted that early experience of day-care is not
necessarily damaging for the child in terms of separation from the
mother (Rutter 1972), and indeed there are many potential positive
benefits for both child and parent in the experience. As well as provid-
ing relief for the family, enabling the parent(s) to develop their own
potential, nurseries and play groups can provide enriching experiences
for the child, enhancing cognitive and social development. Such experi-
ences may be particularly necessary in high stress urban areas, with
poor housing and restricted social amenities, where both parents and
children are at risk for deprivation or disturbance (Garber & Heber
1977, Brown & Harris 1978).
The type of day-care needed in these environments is one which
operates for extended hours, covering the whole year. As such, local
Correspondence: Mr J. C. Clements, Department of Psychology, Institute of
Psychiatry, De Crespigny Park, London SE5 8AF.

0305-1862/82/0500-0123 $02.00© 1982 Blackwell Scientific Publications

123
124 J. C. Clements et al.

authority day nurseries offer a more relevant service than nursery

schools. However, day nurseries have been criticized for being too
care-oriented and not offering sufficient educational experiences
(Hughes et al. 1980). A number of remedies have been suggested for
this, placing teachers in day nurseries, operating combined nursery
centres, link-schemes or a total re-organization and unification of
nursery services. The last named option seems unlikely in the present
economic climate and Hughes et al. (1980) discuss the problems with
the other measures. An alternative approach is to offer additional
training to day nursery staff to enable them to play a more 'educational'
role.
These issues become highlighted when there is the opportunity to
integrate mentally handicapped children into ordinary nursery settings.
Such integration has been commended from many quarters, including
the Warnock report, the Court report, and reports from organizations
concemed with the welfare of mentally handicapped children such as
the Royal Society for Mentally Handicapped Children and Adults,
and Campaign for Mentally Handicapped People. However, simply
placing mentally handicapped children alongside non-handicapped
children does not guarantee any real integration (e.g. Sinson &
Wetherick 1981). Mentally handicapped children may have special
problems in learning and social relationships, which make it difficult
for them to get the most out of unstructured, enriched experience.
They may need structured help to acquire the skills which will enable
them to benefit from the integration experience and to develop to the
full their intellectual potential (e.g. Brinkworth 1973, Garber & Heber
1977, Revill & Blunden 1979). This suggests the need for a strong
educational element in any attempt to effect integration of non-handi-
capped and handicapped children.
The form of such an element is the focus of this paper. There has
been a growing realization that intervention with mentally handicapped
children can only be really effective if it is undertaken by those who
have most contact with the child in his everyday life, that learning and
treatments need to take place in the child's natural environment.
Behaviourally orientated practitioners have been particularly keen in
developing the means of teaching parents and others effective change
techniques (see Callias 1980 for a review). There has been much recent
interest in the UK in the Portage model for working with families who
have pre-school mentally handicapped children (Shearer & Shearer
1976, Revill & Blunden 1979, Pugh 1981). This model combines a very
 Portage system in day nurseries 125

detailed developmental assessment with a set of procedures based upon

behavioural teaching techniques which lead to achievement of short-
term, developmentally appropriate goals. It has proved extremely
popular, and although it has been field-tested primarily as a home-
based service, people from a variety of backgrounds (nursery nursing,
general nursing, teaching) have been successfully taught to use the
model and materials. It would therefore seem to be a potentially
fruitful approach to helping day nursery staff introduce a more struc-
tured educational element in their work.
The present study set out to explore the feasibility of teaching day
nursery staff dealing with handicapped children to use the Portage
methods and materials.

ORGANIZATION AND METHOD

Setting
The target nurseries were located in two inner London boroughs.
The children in these nurseries are mainly 'priority' cases, which means
that many of the children are from disadvantaged backgrounds. How-
ever in both boroughs severely mentally handicapped children were
regarded as 'priority' cases, and both boroughs had a policy of inte-
grating handicapped and non-handicapped children. This might mean
having handicapped and non-handicapped children in the same group
throughout the day, but in addition a number of nurseries had special
care units catering for the more severely disabled. These children
spend a varying proportion of their time with the ordinary nursery
groups, and the rest with their own group. Thus the setting is one
where there is a considerable degree of integration between handi-
capped and non-handicapped children, who are looked after by staff
well-trained in normal child development but with little 'specialist'
knowledge. Both staff and management had expressed the need for
more help in planning activities for the handicapped, and it was agreed
to test out the Portage model as the vehicle for meeting this need.

Subjects
Sixteen nurseries were involved, with two members of staff from each
nursery. The two members were either both senior members from the
nursery (officer-in-charge and deputy) or one senior and one junior
(nursery officer) member of staff.
126 J. C. Clements et al.

Method
Separate courses were run for each borough, though the course con-
tent was very similar. Staff were trained in the use of the Portage
developmental checklists, specifying behavioural objectives, task
analysis, basic behavioural principles for teaching skills and managing
behavioural problems, and writing activity charts. Teaching methods
were lecture, written assignments, role-play workshops and home-
base practical assignments with feed-back (Thomson et al. 1978).
A multiple maintenance procedure was implemented. The course
members continued to meet together with a course leader at infrequent
intervals ( 3 - 4 months) to discuss progress and share problems. In
addition, course leaders visited participants in their own nurseries
between group meetings. In nurseries with special care units regular
programme review meetings were instituted (about every 6 weeks)
and in some nurseries clinical psychology students carried out part of
their placement, thus learning skills themselves and providing extra
input to the nursery staff.

Evaluation
Six months after the course, each nursery was sent a questionnaire
asking about the value of the course, the specific skills staff had used
and were continuing to use, how many staff, children and parents
were involved, and what was needed to sustain the work. Fifteen
replies were received and these form the basis of the Results section.

RESULTS

The applicability of the system

Respondents were offered a 1 - 5 rating scale on the applicability of the
Portage system in day nursery settings, the higher rating reflecting
greater applicability. From 14 completed ratings, the average was
4-3, with no rating below 4. The questionnaire also listed 10 categories
of children, and staff were asked for which they thought the system
most useful. This produced a very even spread of opinion, suggesting
staff found it useful for a wide range of children (e.g. those with
language problems, the socially withdrawn), not just the mentally
handicapped, a point to be taken up later.
 Portage system in day nurseries 127

The use of specific parts of the system

Table 1 indicates use made of the assessment checklists and the activity
charts since the course, and more specifically in the 2 weeks prior to
questionnaire completion. All participants had to use the materials as
part of the course assignment, so that the questionnaire replies indicate
spontaneous usage by the nurseries. As one might expect, in a short
2-week period there is less use of the checklists as the rate at which new
children can be involved is limited by staff resources.
There appears to be some decrease in the use of activity charts, and
discussions with staff indicated that this was the aspect they found
most difficult to sustain. This was primarily because they found it very
time-consuming and often could only find the time outside working
hours (e.g. at home). However, their comments also indicated that they
continued to incorporate the ideas into their everyday work, and 11
replies indicated that in the previous 2 weeks they had spent time
working on a specific skill target with an individual child. Thus most
nurseries seem to be able to sustain individual goal-orientated work with
their children, but in group day-care settings, some modification to
the planning and recording system may be required, or management
may need to ensure that more planning time is available for staff
(a difficult option at a time of cut-backs).

TABLE 1. Use of Portage materials (n = 15)

Since the course In last 2 weeks

Assessment checklist 11 3
Activity chart 12 8

The Portage cards were only available to nurseries on a rota basis, so that
it is not possible to give meaningful information about the usage.

The number of children, staff and parents involved

At the time of questionnaire completion, 44 children had individual
programmes drawn up on Portage lines, and in the 6 months since the
course, 82 children in all had been involved. Some nurseries sustained
long-term programming with selected children (especially the severely
handicapped), others used it to resolve specific, short-term problems
(e.g. with very withdrawn children). It was also encouraging that some
nurseries managed to involve additional staff, and many reported a
128 /. C. Clements et al.

great deal of enthusiasm from other staff to participate in future

courses.
The involvement of parents proved much more difficult. This is a
problem widespread amongst day nurseries (Hughes et al. 1980) in part
reflecting practical difficulties (e.g. parents working full-time), in
part the fact that they serve in these boroughs' very deprived sections
of the community with multiple problems and often with very negative
experiences of agency contacts (e.g. Wahler et al. 1979). There were
some impressive exceptions to this: one nursery was able to arrange for
the mother of an autistic child to visit weekly to plan activities with
nursery staff and the child's psychologist, another arranged a pattern
of shared care with the child attending part-time and a member of staff
visiting the home each week, and a third used the whole approach to
work with a very young mother to teach her child-care and housecraft
skills. But these were exceptions, and clearly this whole area requires
much further thought if effective family involvement is to become
more widespread.

Support required by nurseries to maintain the work

From a selection of six choices (Table 2) respondents were asked to
pick the two things they would find most helpful in sustaining a system
of individual training programmes along Portage lines. The option of
'additional staff was not included as everyone would have certainly
indicated this and so little real information would have been gained.
Many did comment on the problems of sustaining the work, particu-
larly during periods of staff shortage or because of conflicting demands
upon time. And, given these problems, the achievements made are all
the more impressive (see previous section).
The two most popular choices for type of support required were the
need for more external professional input (10 choices) and the need
for further programmes of staff training (nine choices). Particular
reference was made to the need for speech therapy, which reflects
the type of population served by day nurseries in the deprived, multi-
ethnic inner city areas.
The only other category of support significantly indicated (five
choices) was the need for more support from management in terms of
general interest and encouragement. The problem becomes particularly
acute in agencies which need to sustain long-term work with difficult
clients whose rate of progress may be slow or variable, and consideration
may need to be given to specific management procedures needed to
sustain innovation in these areas (Coles & Blunden 1982).
 Portage system in day nurseries 129

TABLE 2. Additional resources required by

nurseries to sustain Portage work

More help from outside professionals 10

More training 9
More support from management 5
More special units within day nurseries 3
More equipment 0
Earlier transition to school 0

DISCUSSION

This study is of short duration and the method of evaluation crude,

but the overwhelmingly positive response of day nursery staff is most
encouraging. Those who work in day nurseries have a good grounding in
child development, both through their training and their extensive
experience. This knowledge base is vital to the successful understanding
of the Portage approach, which relies heavily on ideas drawn from
normal child development but links it to more structured approaches
for stimulating that development. This more structured educational
approach is sometimes thought to be difficult in care-orientated settings,
but the enthusiasm and hard work of the staff involved in this training
programme proves that this is not necessarily the case.
There are of course practical problems and there are definite short-
comings in the Portage materials, as those involved have pointed out.
There is a clear need to adapt the system to group day-care settings,
but this study suggests it to be a feasible task, and the basic approach
embodied in the Portage system seems to have been validated. This in
its turn makes it more likely that the handicapped child will gain
maximum benefit from the opportunity offered by the integration
experience.
Tliis work also raised a number of more general problems faced by
day nurseries. The first of these relates to the difficulties in gaining
parent involvement in their work. At present there is no clear model
for doing this, many nurseries try to run parent groups, but these are
often poorly attended. It has been suggested that parents should have
more say in the management of day nurseries (Hughes et al. 1980) but
this is unlikely to resolve all the problems, desirable though it might be.
130 J. C. Clements et al.

Perhaps greater all-round flexibility would be helpful, enabling nursery

staff to visit more at home and enabling parents to be more involved
in the nursery. This would require a radical reappraisal of many aspects
of the management of the day nursery system.
The second general need to be highlighted was that felt by day
nursery staff for more support, particularly from the therapeutic
professions. This is not just a question of shortage of these services,
but how they are deployed, as staff commented that even where a
child or family is engaged with these services, the nursery may not be
involved in decisions about ways in which they can best help the child.
Particularly in highly deprived areas it seems vital to recognize the key
role day nurseries can play in the social, emotional and cognitive
development of their children.
The present study, albeit limited, is an encouraging indication of
the potential return from helping staff in ordinary day-care situations
deal effectively with special needs children. Much further work needs
to be done to properly develop and evaluate the precise benefits of this
approach, but the achievements made and the enthusiasm of the
response suggests that such study will be richly repaid.

ACKNOWLEDGEMENTS

The work reported here would not have been possible without extensive
help, encouragement and support from the managers of children's
day-care and the training departments of the London boroughs of
Lambeth and Southwark. Special thanks go to Richard Edwards, Betty
Peyton, Peter Rubin and Rona Portwin (Southwark) and Sue Newman
and Greta Sandier (Lambeth). Above all, our thanks go to the matrons
and staff of the day nurseries involved for their enthusiastic participa-
tion in all aspects of the work.

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